A comparative study of access to healthcare and health-related quality of life among adults with disabilities during COVID-19 pandemic in Kakamega County, Kenya

BACKGROUND This study compared the health-related quality of life of adults with disabilities against a control group in Kakamega County. The effect of access to health care on healthrelated quality of life during COVID-19 was also assessed. METHODOLOGY A case-control study was undertaken with 212 persons with disabilities and a comparator group of 212 individuals. Matching between persons with and without disabilities was based on age (+ or -5 years) and sex. The World Health Organisation Quality of Life Questionnaire and WHO Module on disabilities were adopted to assess Health-related Quality of Life (HRQOL) and access to healthcare respectively. Data was analysed using descriptive and inferential statistics. RESULTS Persons with disabilities had significantly lower HRQOL scores compared with the control group (mean difference, 6.89 p<0.01). They were also more likely to encounter barriers to healthcare access. Access to healthcare was positively associated with the HRQOL for the two groups (0.29 p<0.05) but, those with disabilities who experienced limited access to healthcare had lower HRQOL (-0.09 p<0.038). CONCLUSION Disability was associated with lower HRQOL. In both groups, access to healthcare was linked to higher HRQOL. Policies to enhance access to healthcare for persons with disabilities; subsidies on medical costs, and ensuring disability-friendly hospitals, are imperative. Awareness of the rights of persons with disabilities, and solving inequities in education and labour market access, is necessary to achieve full participation of persons with disabilities in social life.